HomeMy WebLinkAbout2646 STATE ST; ; CBR2020-0935; Recycle( City of
Carlsbad
CONSTRUCTION WASTE
MANAGEMENT PLAN
8-59
Development Services
Building Division
1635 Faraday Avenue
760-602-2719
www.carlsbadca.gov
Many of the materials generated from your project can be recycled. You are required to list materials that will be
reused, recycled or disposed from your project. If you have questions about the recycling requirement or completing
this form, please contact Waste Management at (760) 929-9400, a certified C&D recycler, or the Carlsbad Building
Division at (760) 602-2700. Please note: Unless you are self-hauling, Waste Management or approved haulers must be
used for all construction projects within the City of Carlsbad.
PART 1 Complete and submit this form when applying for a Building Permit . Note: Permits will not be issued
without a complet ed Construction Waste M anagement Plan.
Permit No. 6«2.oi'i-002 6
Project Address ,<lie/(, S"fcc,h, $'+.
Applicant Name
Project Title
C 4 ..-f s b c.J
Last First
APN ;lo3-/ot-ZC -00
Architect Other
00--
Applicant Address 5"8t/£ t\-ve111dt4 btOMl J Sk 1'38, Gt1sbad I CA-f2,,00~
Phone ( 7Ceo I qq q -2 '~ (, E-mail Address rod ~ rt) ~ tso r V fl<mJir\C. CO""-
Applicant Mailing Address
(if different than project address)
Project Type
(check all thot opply):
Residential Commercial
~ □
Public Building □ 8, ':l s-\-ov,v tow"'hc,,-ne "''~~ OY\~ bv~ \c\u,~
Industrial □
Brief Description
Project Size \ S ~00 Estimated Cost of Project $ _ ___:(s;,~000-C--"-Jl-'0=-0=-=(.)'---------
(square footage)
Please check the appropriate box:
~ I plan on using WASTE MANAGEMENT roll-off bin(s) for all materials and will provide all receipts after construction.
~ I plan on self-hauling to a certified recycling facility and will provide all receipts after construction.
D This is a proposed LEED certified project and I plan on separating materials on site in conjunction with WASTE
MANAGEME NT.
Acknowledgement: I certify under penalty of perjury under the laws of the State of California that the information
provided in and with this form pertains to construction and demolition debris generated only from the project listed
in PART 1, that I have reviewed the accuracy of the information, and that the information is true and correct to t he
best of my knowledge and belief. ~~ /)
Print Name l(og"-ej A -~ P Signature _ ______:_ ~ Date 5. /. 2,1.)
A~r13;"d ~r i?ef• ,
'j"\ ~ • ,-(c:ir. (' 'P(0.06'.<!>~ ~ r\)n(M SI :/ic. t-'fl{j ' ~ r Page 1 of4 Rev. 11112118
PART 1 Complete, obtain signature, and submit this form when applying for a Building Permit. Note: Permits will
(cont'd) not be issued without a completed Construction Waste Management Plan.
DEBRIS RECYCLING ESTIMATE:
-.-...:::11--!llln,-• Permit No. Q 2.ol~ -oo 2.( Project Title ~e4. Gl(ltS
Project Address 2<,~<, S~te ~-, urlsb~a q'llXJ8 APN .lo3-LOI-U>~oo
Applicant Name 'Pro~"-.e.t ~c>{ vti~' rl'j,. Phone ( 7'°) 999 -2 I L/{,
Last First
• : Complete the followln1 table with estimated waste tonna1e to be 1enerated by your project .
This is your plan for construction waste management. Changes can be made on the final recycle report.
Goal: the dlvenlon rate shall be 65" by wel1hts of debris.
A B C
Material Type Estimated Place a(✓) check Place a(✓) check next Place a(✓) check next
Waste Quantity next to items to be to items to be to items to be
(tons) reused or salvaged recycled disposed at landfill
Complete this line of the table only If
only using WASTE MANAGEMENT
roll-off bins. /. z. ✓ Mixed C&D Debris
Asphalt & Concrete I 'J... ✓
Brick/ Masonry/ Tile NIA No"e
Mixed Inert Debris / ✓
Cabinets, Doors, Fixtures, \ "'°"~ * Windows (circle all that apply)
~Carpet \ ,Jon,
Carpet Padding/ Foam Nof\~ ~
Cardboard I ,Jon~
Ceiling Tile (acoustic) I ,Jon,•
Drywall (used, new, scrap) N/1t ,Jot\~ ,...
Landscape Debris (brush, trees, i...o ✓ stumps, etc.) No dirt.
Unpainted Wood & Pallets 2.o ✓
Roofing Materials NIA No"' .,..
Scrap Metal ,~l. otka..-✓
Stucco f'i/A "lo"e
Other: 4.o ✓
TOTAL -Jo,4 ~J -
•
To meet 65% Diversion Requirement (estimate) /0.'f ~ X 0.65 = ~-S tons
IL,~~ Tat ~ Waste from above Minimum Required Diversion
Contractor/Owner Signature ' . -Date S../.1..o -, "
Page2of4 Rev. 11112/18
In\ Pacific Trans Environmental Services, Inc. \:!:J 1452 North Johnson Avenue, El Cajon, CA 92020 (619) 441 -1818 Fax (619) 441-2535
JANUS CORP.
ATTN: ACCOUNTS PAYABLE
1220 KEYSTONE WAY
VISTA, CA 92081
Quantity Description --WORK ORDER 83119 10/03/2019
PROVIDE WASTE DISPOSAL AND
TRANSPORTATION SERVICES
NAVAL BASE SAN DIEGO
018969622JJK U.S. ECOLOGY
16 LEAD PAINT CHIPS PER TON
1 TRANSPORTATION PICK UP FEE
1 TRANSPORTATION TO USE
1 ENERGY SECURITY SERVICE FEE
Thank you for your business.
THANK YOU!
BY:
Invoice
UC l 2 3 201~ j Date Invoice #
10/11/2019 62841
P.O. No. Terms Project
Net30
Rate Amount
175.00 2,800.00
300.00 300.00
2,050.00 2,050.00
566.50 566.50
58~-i 03
~rl ,T [r-~[Q) '"710
Total $5,716.50
PACIFIC TRANS ENVIRONMENTAL SERVICES, INC.
1452 N Johnson Avenue, El Cajon, CA •zozo
ce11r441-1ai1 Fu ce11> il41-.253s ·
WORK ORDER: 83119 Date: 10/03/2.019
C°'"'alll: JANUS CORPORATION
C...,.IDr ._..: NAVAL BASE SAN DIEGO
Addr.-: BLOG. 61
City: SAN DIEGO, CALIFORNIA 92136
Contact:
Description of Servk:c
PROVIDE ORUM TRANSPORT TO USE
Qty Proflle Commo11 Name/DMcrtptk>n ConL_Type
TSDfs U.S. ECOLOGY
Mllnlf•t #: 018969622.lJK
1.00 PT1&-0754 LEAD PAINT CHIPS 66G-DM
SERVICES
1.00 TRANSPORTATION (PICK UP FEE)
Pege 1 of 1
P.O.#:
EPA ID: CA6170024289
Phone:
Credit Tennc
Salu Rep: TREVORHEMBERA
Manl•ts Speel■IIMt:
P/u DRUM FROM NBSD TRANSPOIITTO USE
ONSITE: 12PM I LOC: NBSD BLDG 61 POC, ~~ ::ONSITE
Truck#: -~-~-~-c5_1 fd_Cf_l,_1 ,_2 L_
► □-----Name CullorTMtr Please Print TtneSt111t:
Delle: ~ Start:
DIie: Start:
Ir .. ./
TmeStDp: O'S' ----
SIDp:
Stop;
DIiie: Slllrt: Slnp:
The underslgned hereby IWlhorlras and requests PTES to pefform the wortc specified llbov1I.
ChadH
See Rewrse Side for Terms and Conditions
-.
O US ecologyNEVAOA
Ticket: 209516
us Ecology Nevada
ll Miles south of Beatty
Beatty, NV 89003
Vehicle: 122
Manifest #:018969613JJK
Date:
Time In:
Time Out:
In:
Out:
Net:
10/3/2019
02:09 PM
03:10 PM
49220 lb
44580 lb
4640 lb
Net Tons:2 .32 tons
Net Kg: 2105 kilograms
..
. 0MB No. 2050-0008
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